{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:22:24Z","timestamp":1772018544176,"version":"3.50.1"},"reference-count":19,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Treatment of hypoparathyroidism with activated vitamin D and calcium carbonate is associated with increased risk of hypercalcemia, hypercalciuria, and nephrocalcinosis. These complications are usually due to inadvertent overdose of medications. We present a case of a 6-year-old boy with hypoparathyroidism, sensorineural deafness, and renal dysplasia (HDR) syndrome and feeding difficulties who developed severe hypercalcemia twice, which was caused not just by medication. Both episodes of calcium overload were related to excessive dietary calcium intake from enteral formula. After rehydration and diet change, his blood calcium and urine calcium\/creatinine ratio normalized and remained normal with the same dose of calcitriol without calcium carbonate during the following 2 years. This case underscores the importance of assessment of dietary calcium intake in children with hypoparathyroidism, especially those receiving enteral formula. It shows that calcium intake from enteral formula may even become excessive when the volume of formula is increased in pursuit of more calories, and long-term treatment of hypoparathyroidism could be successful with calcitriol without calcium supplement if dietary calcium intake is sufficient. Use of blenderized tube feeding instead of commercial enteral formula in a child with hypoparathyroidism makes it possible to increase calorie intake without causing dietary calcium excess.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag013","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T12:44:23Z","timestamp":1768481063000},"source":"Crossref","is-referenced-by-count":0,"title":["Unexpected severe hypercalcemia in a 6-year-old child with hypoparathyroidism and feeding difficulties"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5781-8967","authenticated-orcid":false,"given":"Michael Yuri","family":"Torchinsky","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Illinois College of Medicine , Peoria, IL 61603 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark Daniel","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Illinois College of Medicine , Peoria, IL 61603 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"18","key":"2026022505341546900_luag013-B1","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1056\/NEJMcp1800213","article-title":"Hypoparathyroidism","volume":"380","author":"Gafni","year":"2019","journal-title":"N Engl J Med"},{"issue":"11","key":"2026022505341546900_luag013-B2","doi-asserted-by":"crossref","first-page":"4106","DOI":"10.1210\/jc.2015-2257","article-title":"The impact of hypoparathyroidism on the kidney in children: long-term retrospective follow-up study","volume":"100","author":"Levy","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"2026022505341546900_luag013-B3","doi-asserted-by":"crossref","first-page":"4507","DOI":"10.1210\/jc.2012-1808","article-title":"Long-term follow-up of patients with hypoparathyroidism","volume":"97","author":"Mitchell","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"15","key":"2026022505341546900_luag013-B4","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1056\/NEJM199210083271506","article-title":"Brief report: autosomal dominant familial hypoparathyroidism, sensorineural deafness, and renal dysplasia","volume":"327","author":"Bilous","year":"1992","journal-title":"N Engl J Med"},{"issue":"4","key":"2026022505341546900_luag013-B5","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1002\/(SICI)1096-8628(19971231)73:4<416::AID-AJMG9>3.0.CO;2-L","article-title":"HDR syndrome (hypoparathyroidism, sensorineural deafness, renal dysplasia) associated with del(10)(p13)","volume":"73","author":"Hasegawa","year":"1997","journal-title":"Am J Med Genet"},{"issue":"6","key":"2026022505341546900_luag013-B6","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1002\/ajmg.a.38693","article-title":"Barakat syndrome revisited","volume":"176","author":"Barakat","year":"2018","journal-title":"Am J Med Genet"},{"key":"2026022505341546900_luag013-B7","first-page":"1","article-title":"Hypoparathyroidism, sensorineural deafness, and renal disease syndrome presenting with febrile seizures and hypocalcemia","volume":"1","author":"Gandolfi","year":"2023","journal-title":"J Clin Endocrinol Metab Case Reports"},{"key":"2026022505341546900_luag013-B8","volume-title":"Dietary Reference Intakes for Calcium and Vitamin D","author":"Institute of Medicine","year":"2011"},{"issue":"4","key":"2026022505341546900_luag013-B9","doi-asserted-by":"crossref","first-page":"e1229","DOI":"10.1542\/peds.2014-2173","article-title":"Optimizing bone health in children and adolescents","volume":"134","author":"Golden","year":"2014","journal-title":"Pediatrics"},{"issue":"8","key":"2026022505341546900_luag013-B10","doi-asserted-by":"crossref","first-page":"3539","DOI":"10.1210\/jc.2002-021935","article-title":"Nutritional rickets with normal circulating 25-hydroxyvitamin D: a call for reexamining the role of dietary calcium intake in north American infants","volume":"88","author":"DeLucia","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026022505341546900_luag013-B11","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1210\/jc.2015-2175","article-title":"Global consensus recommendations on prevention and management of nutritional rickets","volume":"101","author":"Munns","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2026022505341546900_luag013-B12","first-page":"732","volume-title":"The Harriet Lane Handbook: a Manual for Pediatric House Officers","author":"Lee","year":"2018","edition":"21st ed"},{"issue":"2","key":"2026022505341546900_luag013-B13","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-15-0628","article-title":"European Society of Endocrinology clinical guideline: treatment of chronic hypoparathyroidism in adults","volume":"173","author":"Bollerslev","year":"2015","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2026022505341546900_luag013-B14","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1177\/0148607110377797","article-title":"Pureed by gastrostomy tube diet improves gagging and retching in children with fundoplication","volume":"35","author":"Pentiuk","year":"2011","journal-title":"J Parenter Enteral Nutr"},{"key":"2026022505341546900_luag013-B15","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jpeds.2019.04.023","article-title":"Health outcomes and quality of life indices of children receiving blenderized feeds via enteral tube","volume":"211","author":"Hron B","year":"2019","journal-title":"J Pediatr"},{"issue":"3","key":"2026022505341546900_luag013-B16","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1002\/ncp.10493","article-title":"Blenderized tube feeding: health outcomes and review of homemade and commercially prepared products","volume":"35","author":"Bennett","year":"2020","journal-title":"Nutr Clin Pract"},{"issue":"669","key":"2026022505341546900_luag013-B17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1136\/pgmj.57.669.431","article-title":"Hypercalcemia in alphacalcidol therapy","volume":"57","author":"Patterson","year":"1981","journal-title":"Postgrad Med J"},{"issue":"6","key":"2026022505341546900_luag013-B18","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1046\/j.1365-2710.2001.00376.x","article-title":"Hypercalcemia and idiopathic hypoparathyroidism","volume":"26","author":"Schroth","year":"2001","journal-title":"Clin Pharmacol Ther"},{"issue":"6","key":"2026022505341546900_luag013-B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/hmed.2021.0624","article-title":"Immobilization hypercalcemia","volume":"83","author":"Mifsud","year":"2022","journal-title":"Br J Hosp Med"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/3\/luag013\/67106987\/luag013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/3\/luag013\/67106987\/luag013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T10:34:24Z","timestamp":1772015664000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luag013\/8497189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2,23]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luag013","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,2,23]]},"article-number":"luag013"}}